Can I go back to cellcept?

Here is My Question:
Hi I have been on cellcept for 11 years now. For the first 6 years I did not have a relapse and my dosage was reduced. But 5 years ago got a relapse and have been back on the original dosage and now every year I get a small relapse. I have been advised to think about Ocrevus. I wanted to know if there will be some side effects and if it is possible to go back from Ocrevus to cellcept if needed. Thanks for the inputs.

Answer:
Yes, you could in theory go back to cellcept if you wanted to.  Ocrevus is a b-cell biologic to treat MS (and there are others including Rituximab and Ofatumumab).  These therapies are considered highly effective in the treatment of MS while cellcept has been used off label for more mild cases (although not used much now due to the myriad of approved therapies for this disease).  Cellcept is also used for MS mimicking conditions such as NMO.  I’d suggest speaking with your treating provider to better understand the recommendation to switch (is it due to confirmed new inflammatory disease or just because of various symptoms in the absence of inflammation on your MRI scans or confirmed by neurologic examination in the clinic?).

You can read more about the b-cell biologics and efficacy, safety, side effects by searching under “Rituximab” which is the oldest such therapy, or “Ocrevus”.

A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente